SARS-CoV-2 Neutralizing Antibody LY-CoV555 in Outpatients with Covid-19.

Abstract

BACKGROUND:

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (Covid-19), which is most frequently mild yet can be severe and life-threatening. Virus-neutralizing monoclonal antibodies are predicted to reduce viral load, ameliorate symptoms, and prevent hospitalization.

METHODS:

In this ongoing phase 2 trial involving outpatients with recently diagnosed mild or moderate Covid-19, we randomly assigned 452 patients to receive a single intravenous infusion of neutralizing antibody LY-CoV555 in one of three doses (700 mg, 2800 mg, or 7000 mg) or placebo and evaluated the quantitative virologic end points and clinical outcomes. The primary outcome was the change from baseline in the viral load at day 11. The results of a preplanned interim analysis as of September 5, 2020, are reported here.

RESULTS:

At the time of the interim analysis, the observed mean decrease from baseline in the log viral load for the entire population was -3.81, for an elimination of more than 99.97% of viral RNA. For patients who received the 2800-mg dose of LY-CoV555, the difference from placebo in the decrease from baseline was -0.53 (95% confidence interval [CI], -0.98 to -0.08; P = 0.02), for a viral load that was lower by a factor of 3.4. Smaller differences from placebo in the change from baseline were observed among the patients who received the 700-mg dose (-0.20; 95% CI, -0.66 to 0.25; P = 0.38) or the 7000-mg dose (0.09; 95% CI, -0.37 to 0.55; P = 0.70). On days 2 to 6, the patients who received LY-CoV555 had a slightly lower severity of symptoms than those who received placebo. The percentage of patients who had a Covid-19-related hospitalization or visit to an emergency department was 1.6% in the LY-CoV555 group and 6.3% in the placebo group.

CONCLUSIONS:

In this interim analysis of a phase 2 trial, one of three doses of neutralizing antibody LY-CoV555 appeared to accelerate the natural decline in viral load over time, whereas the other doses had not by day 11. (Funded by Eli Lilly; BLAZE-1 ClinicalTrials.gov number, NCT04427501.).

• Authors: Peter Chen, Ajay Nirula, Barry Heller, Robert L Gottlieb, Joseph Boscia, Jason Morris, Gregory Huhn, Jose Cardona, Bharat Mocherla, Valentina Stosor, Imad Shawa, Andrew C Adams, Jacob Van Naarden, Kenneth L Custer, Lei Shen, Michael Durante, Gerard Oakley, Andrew E Schade, Janelle Sabo, Dipak R Patel, Paul Klekotka, Daniel M Skovronsky, BLAZE-1 Investigators
• Journal: The New England journal of medicine (N Engl J Med) Vol. 384 Issue 3 Pg. 229-237 (01 21 2021) ISSN: 1533-4406 [Electronic] United States
• PMID: 33113295 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Massachusetts Medical Society.

Chemical References

• Antibodies, Monoclonal, Humanized
• Antibodies, Neutralizing
• Immunologic Factors
• RNA, Viral
• bamlanivimab

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects)
• Antibodies, Neutralizing (administration & dosage, adverse effects)
• COVID-19 (virology)
• Dose-Response Relationship, Drug
• Double-Blind Method
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Immunologic Factors (administration & dosage, adverse effects)
• Male
• Middle Aged
• Outpatients
• RNA, Viral (blood)
• Reverse Transcriptase Polymerase Chain Reaction
• SARS-CoV-2 (genetics, isolation & purification)
• Severity of Illness Index
• Viral Load (drug effects)
• Young Adult
• COVID-19 Drug Treatment